Can The Inner Corner Of My Eyes Be Turned Down?

Q: Dr. Eppley, I’m curious if it’s possible to modify the medial canthus to be more downturned or positioned slightly lower, like shown in the photo below. I understand this area is very difficult to alter due to the intricate anatomy, such as the nasolacrimal duct and puncta, which is why most surgeons avoid operating on it for purely cosmetic purposes. Also not to mention the overall nicheness and subtlety of the area make it a very rare procedure. That said, I’m wondering if it’s feasible to lower the medial canthus by just 3mm or so, and if so, how this could be done. I’ve heard that external soft tissue procedures, like a Z-plasty, could be used to stretch it downward, emulating it, but I question if such a method could achieve the extent shown in the photo, and I’m also unsure about its long-term stability. Thank you for your time!

A:You do realize that the image you have shown is not real and those are photoshopped changes. That being said the inner eye corner can be lowered, perhaps not as much is shown in the altered image, by changing the position of the lacrimal lake not the medial canthus, by a Y-V advancement.

Dr. Barry Eppley

World-Renowned Plastic Surgeon